According to Resolution No. I’m thinking to go to nursing school in the U.S. and wanting to make sure that I can apply what I learn here to US hospitals..Thank you so much for reading my message and have a good day! A validation study of the content of the defining characteristics of NDs anxiety and fear [17] emphasised the difficult differentiation of these two diagnoses. The authors declare that there are no conflicts of interest. Jomar RT and Bispo VRS (2014) The most common nursing diagnosis among adults/seniors hospitalised with cancer: integrative review ecancer 8 462, 4. Requirements for documentation availability prior to ordering chemotherapy regimens (e.g. Bergamasco EC et al (2004) Diagnosis of fear and anxiety: content validation for the burned patient Rev Bras Enferm 57(2) 170–177 https://doi.org/10.1590/S0034-71672004000200008 PMID: 15535515, 18. Clinical practice guidelines in oncology J Natl Compr Canc Netw 5(10) 1054–1078 PMID: 18053429, 15. This text for beginning and advanced oncology nurses integrates the nursing process, including nursing diagnosis, with the administration of cancer chemotherapeutic agents. Stina APN, Zamarioli CM and Carvalho EC (2015) Effect of educational video on the student’s knowledge about oral hygiene of patients undergoing chemotherapy Esc Anna Nery 19 (2) 220–225 https://doi.org/10.5935/1414-8145.20150028, 21. As all the studies selected for this review have a descriptive character, we must highlight the low level of the quality of the evidence generated by them [11]. This is of greater importance among women who have had a mastectomy and individuals with intestinal stomas who undergo antineoplastic chemotherapy, as reported in articles that are part of this review [7–8, 10]. Staged versus conventional nursing for patients receiving chemotherapy for advanced non-small cell lung cancer: a before and after study. 0000011776 00000 n 0000012765 00000 n Here are some factors that may be related to nursing diagnosis Nausea: Treatment-related: 1. As a search strategy, 12 different combinations of the descriptors were used: Nursing Process (Nursing Process), Nursing Diagnosis (Nursing Diagnosis), Neoplasms (Neoplasms), Chemotherapy (Drug Therapy) and Outpatients Clinics Hospital (Outpatient Clinics Hospital) (Table 1). Silva PO and Gorini MIPC (2008) Nursing diagnosis of patients with colorectal neoplasia undergoing chemotherapy treatment – a qualitative research Online Braz J Nurs 7(2) 27 https://doi.org/10.5935/1676-4285.20081521, 9. Increased ICP 7. In the MEDLINE database, two studies were preselected, in CINAHL nine, in LILACS eight, in BDENF three, and SciELO none, for a total of 22 studies. Nursing Diagnosis: Risk for infection related to inadequate defenses, secondary and immune system (the effect of chemotherapy / radiation), malnutrition, invasive procedures. Antineoplastic chemotherapy was indicated by a review study on body image in cancer patients [12] as one of the factors responsible for the occurrence of this ND is due to one of its most common side effects: alopecia. RAFG participated in the bibliographic research, data analysis and interpretation, critical review, and final approval of the article. If used as a guide for the investigation of NDs among adult/elderly users of oncology outpatient services, the results of this review may contribute to the advancement and improvement of the nursing process. 0000008572 00000 n Given the scarcity of publications on the diagnostic phase of the oncology nursing process, the 40 NDs identified by the present review point to the complexity of the care provided to patients undergoing chemotherapy in an outpatient setting. Bittencourt AR et al (2009) The theme of body image in the national scientific production of nursing: a highlight for cancer patients Rev bras cancerol 55(3) 271–278, 13. The present study deals with the diagnostic stage of the nursing process. 0000108271 00000 n Among the countries of origin of the studies, Brazil stood out with three of the four articles selected [7–8, 10], of which only one was not published in Portuguese, but in Spanish [9]. Methods: Review of studies published in Portuguese, English, or Spanish which were searched in five electronic databases in March 2016, using the descriptors nursing process, nursing diagnosis, neoplasms, drug therapy and hospital outpatient clinic. . The ND pattern of ineffective sexuality, defined as an expression of concern about one’s own sexuality, was also described by two studies selected to compose the review [7, 9]. As for the data source, only one article used the patient’s chart in addition to the interview and physical examination [8]. An integrative review on ND nausea, concluded that young age, female gender, motion sickness, emetic potential of chemotherapy, anxiety, conditioned stimulus and expectation of nausea after treatment are the most frequent factors related to the occurrence of this condition in patients submitted to antineoplastic chemotherapy [18]. The prevalence of diagnosis was 40.8% in a sample of 170 patients. The selection of descriptors used in the search process of the studies was done through consultation of the Bowel obstruction 2. Overview Antineoplastic Chemotherapy Anti-: Against -neoplastic: abnormal cells or growth Chemo-: chemical, drug -therapy: given for therapeutic benefit Drugs given to kill cancer cells and/or stop their growth Administration of Chemo Patient Safety Staff Safety Infection Prevention Immunocompromise Central Line Associated Blood Stream Infections (CLABSIs) Patient Education … FINDINGS. Two key nursing diagnoses are related to alopecia. In addition to their defining characteristics being similar and mostly subjective, these NDs are often presented concomitantly by the same patient, as observed in a selected article to compose the present review [8]. Narchi NZ and Gutiérrez MGR (1997) Nursing Diagnoses in women with breast cancer undergoing anticancer chemotherapy Paul nurse Act 10(1) 33–42, 8. It is worth mentioning that nurses can play an important role as educators by providing information on cancer, antineoplastic chemotherapy, and its potential complications in order to answer questions and promote the health of patients under treatment. Nursing Interventions Rationale; Monitor for any signs of bleeding and febrile episodes; Note laboratory findings: WBC, platelet count, Hct, and absolute neutrophil count. 0000159776 00000 n Objective: To search in the scientific literature for nursing diagnoses identified in adult/elderly patients undergoing antineoplastic chemotherapy in an outpatient setting. Nausea and diarrhoea are frequent toxic effects caused by antineoplastic chemotherapy [4]. Inadequate secondary defenses and immunosuppression, e.g., bone marrow suppression (dose-limiting side effect of both chemotherapy and radiation). Nursing Diagnosis Risk for Infection Risk factors may include. In view of this, it is important to note that anxiety and fear are among the defining characteristics of ND. E-mail: rafaeljomar@yahoo.com.br. The exclusion criteria adopted were literature reviews, updates, experience reports or any other format where it was not stated that the results were obtained from collection of data from adults/seniors undergoing outpatient chemotherapy (interview and/or physical examination) or review of their medical records. Providing a solution of hydrogen … Tube feeding Biophysical: 1. They eventually crowd out the good cells which impairs the growth and function of healthy cells. %PDF-1.4 %���� 0000001601 00000 n Tavares Jomar Rafael, Furtado Gomes Rebeca Anselmo, Carvalho Leite Dayana, Ferraz Gomes Helena, Peres Ellen Marcia, Fuentes Perez Junior Eugenio (2017) The form also allowed us to obtain information on the authors, country, and year of publication of the article, with objectives, design, data source, sample type, conclusions and recommendations for nursing practice. Silveira Y et al (2013) Development of an electronic guide for chemotherapy: contribution to a safe nursing practice Rev Bras Inov Tecnol Saúde 3(3) 45–54, 23. 0000108546 00000 n 0000044850 00000 n In March 2016, with no restrictions on the nature of the study or language, two authors independently searched for indexed studies in the electronic databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), and Nursing Database (BDENF). One of its defining characteristics stands out: frustration about the inability to perform normal activities [1]. Table 2. 0000010972 00000 n Federal Nursing Council (2009) Resolution COFEN 358/2009. 0000104983 00000 n There are many types of leukemia. 0000002213 00000 n In women, breast (28.1%), intestinal (8.6%), cervical (7.9%), lung (5.3%), and stomach (3.7%) cancers will be among the main types. Validate the nursing diagnosis spiritual distress in cancer patients. 0000007756 00000 n Diarrhoea, defined as the elimination of loose and unformed stools [1], and nausea, defined as a subjective phenomenon of unpleasant sensation in the back of the throat and stomach, which may or may not result in vomiting [1] , were also identified by half of the studies selected to compose the review [7, 9], such as the unbalanced nutrition ND: lower than the body needs [7–8], whose definition is insufficient intake of nutrients to satisfy the metabolic needs [1]. Malnutrition, chronic disease process; Invasive procedures; Desired Outcomes. Implications concerning adverse drug reactions consists of precise information regarding nursing interventions and the rationale for implementation. To allow for easy reference, a tabular format is used to present systematically organized adverse reactions related to cancer chemotherapy. The estimation for Brazil for the years 2016–2017 [5] indicates the occurrence of about 600,000 new cases of cancer. 0000010164 00000 n This is a review of the scientific literature which involved gathering, analysing and synthesising, in a systematic and orderly way, results of studies that investigated NDs in adults and seniors undergoing outpatient chemotherapy according to the following steps: formulation of the guiding question, search of the study literature, interpretation and synthesis of the evidence from the selected studies. Rodrigues FSS and Polidori MM (2012) Confrontation and resilience of patients undergoing chemotherapy and their relatives Rev bras cancerol 58(4) 619–627, 5. The selection of descriptors used in the search process of the studies was done through consultation of the DeCs (BIREME Descriptors in Health Sciences) and MeSH (Pubmed Medical Subject Headings). METHOD. Leukemia is cancer of the blood forming tissues and usually involves the white blood cells. This inability—momentary, it is worth emphasising—is probably due to the toxic effects of antineoplastic chemotherapy, such as fatigue, one of the most prevalent symptoms in cancer patients undergoing treatment [13]. The process described earlier was performed by the same authors who searched for studies and any disagreements were resolved through consultation with a third author. 0000008316 00000 n Combinations of descriptors used as a search strategy for the studies. To explore the use of NANDA, NIC, and NOC classification systems in the psychological and physical care of patients experiencing chemotherapy‐induced alopecia. 0000159410 00000 n 0000003210 00000 n h�b```b``��������A��X�X8�l~m`K]`'23��ޅ���@�g Nursing care plans for cancer involves assessment, support for therapies (e.g., chemotherapy, radiation, etc. After non-melanoma skin cancers, the most frequent types of cancers in men will be prostate (28.6%), lung (8.1%), intestinal (7.8%), stomach (6.0%), and oral (5.2%). In addition to the pain that can be generated by the tumour itself, this therapy can cause several painful side effects such as headache, myalgia, gastralgia, burning and tingling [4]. Side effects can range in severity from unpleasant to life threatening (as in severe infection) and must be weighed against the need to treat the cancer. 4. Only one selected article [10] did not identify the fatigue ND. 0000001753 00000 n (2011). Defined as vulnerability to invasion and multiplication of pathogenic organisms, which may compromise health, risk of infection [1] was identified by half of the articles reviewed [8–9]. 0000068821 00000 n Nursing Diagnosis for Patients undergoing Chemotherapy: Risk for infection related to malnutrition as evidenced by low BMI. Considering the lack of publications on ND in oncology and the fact that knowledge of common NDs in this area can strengthen the nursing process, in addition to providing oncology nurses with support for decision-making, choosing the best interventions, and performing a quality clinical practice, the objective of this study was to search in the scientific literature for NDs identified in adults/seniors undergoing antineoplastic chemotherapy in an outpatient setting. A study that evaluated the perception of anxiety in patients submitted to antineoplastic chemotherapy pointed out the side effects of this therapy as one of the main factors responsible for this feeling [15]. All patients receiving chemotherapy for childhood cancer or as pre conditioning for a haematopoietic stem cell transplant (HSCT) require ongoing assessment of the incidence and severity of nausea and vomiting.It is the responsibility of nursing staff to regularly assess patients for signs and symptoms of CINV and decide on subsequent methods of management in consultation with the medical team. Increasing the frequency of loose stools, unformed or liquid, can impair the permanence of food ingested in the gastrointestinal system long enough for absorption of different nutrients to occur properly [19]. of the nurse's role in cancer chemotherapy. The bone marrow produces abnormal white blood cells that do not function properly. In relation to NANDA International [1] Taxonomies, only one article did not specify which Taxonomy was used [7], while all others used Taxonomy II. 0000009428 00000 n The social stigma of cancer may lead patients to experience feelings of dread in the face of disease [8]. It is possible that the change in the health status of a family member [1]—one of its related factors—is mainly responsible for its occurrence in adults/elderly patients submitted to outpatient antineoplastic chemotherapy. Manrique FMC and Pedraza HMP (2008) Prevalence of nursing diagnoses in people undergoing cancer treatment Invest Educ Enferm 26(2) 212–217, 10. Nursing Interventions: -The nurse will perform hand hygiene before and after patient contact.-The nurse will don the proper PPE before patient contact.-The nurse will assess pt’s family, friends, and other hospital staff understanding of hand hygiene and personal protective equipment usage. Standards and Competencies for Cancer Chemotherapy Nursing Practice. Nursing diagnoses in adults/elderly undergoing outpatient antineoplastic chemotherapy, according to domain and class (n/N)*. Defined as a vague and uncomfortable feeling of discomfort or fear, of apprehension caused by the anticipation of danger, the anxiety disorder is a warning sign that draws attention to an imminent danger and allows the individual to take action to deal with the threat [1]. As all studies selected for the review are descriptive, the low level of quality of the evidence generated by them is highlighted: level 6, on a scale of 1 to 7, where level 1 represents the highest quality Evidence [11]. Regarding the type of sample, all studies had non-probabilistic samples, that is, samples of convenience. �vx?d�@��r��n>g@'��v��v�,�Y�R@An~�ǁǮ�)9�����u�O�" M��;Y��=��xYsQ�҉�lr�2Y�tai����o�� ��`��ke�dZ�%dz7��8�H�ƭ���^6��bz�f�j�G+n M+9�1/3%ÐUB��S��ص��3J�B� Therefore, nurses have a great responsibility for the planning of nursing care in oncology, especially regarding decision making and actions aimed at solving problems identified in the diagnostic stage [3]. Knowledge of diagnosis, treatment and its side‐effects in patients receiving chemotherapy for cancer M. C. COUGHLAN BNS, RPN, RGN, RNT School of Nursing, … Twitter. 0000013700 00000 n Gastrointestinal diseases 6. A selected study [8] for this review states that special attention should be given to the impaired home maintenance ND whose definition is the inability to independently maintain a safe environment for growth promotion [1]. Keywords: oncology nursing, nursing process, nursing diagnosis, drug therapy/antineoplastic agents, ambulatory care. This is one of the major NDs faced by oncology nurses due to the great predisposition of patients undergoing antineoplastic chemotherapy to contract infections, since this modality of cancer treatment can cause immunosuppression [4, 22]. Findings. Role of nurses in the assessment and management of chemotherapy-related side effects in cancer patients Helen Roe,1 Elaine Lennan2 1Department of Clinical Oncology, North Cumbria University Hospitals NHS Trust, Carlisle, 2Chemotherapy Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK Abstract: Chemotherapy services in the UK have been the subject of … Evaluate painful effects of particular therapies, such as surgery, radiation, chemotherapy, or biotherapy. The ND Interrupted family process, defined as change in relationships and/or family functioning [1], was described by two studies selected for review [7, 9]. Copyright: © the authors; licensee ecancermedicalscience. Infections 8. 0000122752 00000 n Cough 5. Here are five (5) nursing care plans (NCP) and nursing diagnosis for patients with leukemia: Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared side effects of cancer treatment for patients with cancer (de Boer-Dennert et al., 1997; Hickok et al., 2003). Defined as a response to the perceived threat that is consciously recognised as a hazard, the ND Fear [1] was also described by half of the review articles [8–9]. During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Table 1. Cancer 4. The criteria for inclusion of studies in the review were as follows: be published in original article format in English, Spanish, or Portuguese; having as study subjects adult and/or elderly individuals undergoing antineoplastic chemotherapy on an outpatient basis and; the NDs being identified in this population, according to NANDA International [1] Taxonomies I or II. Oliveira SKP et al (2010) Systematization of nursing care for mastectomized women Cogitare Enferm 15(2) 319–326, 11. Mock V et al (2007) Cancer-related fatigue. 0000159449 00000 n The goal of this study was to identify, according to NANDA International, the most common nursing diagnosis among adults/seniors with cancer who are hospitalised. 0000009173 00000 n Postoperative 4. Excluding non-melanoma skin cancer (approximately 180,000 new cases), there will be about 420,000 new cases of cancer, where prostate (61,000) and breast (58,000) cancers will be the most common. 0000007493 00000 n North American Nursing Diagnosis Association (2015) Nursing diagnoses of NANDA: definitions and classification 2015-2017 (Porto Alegre: Artmed), 2. 0000005587 00000 n Campos MPO et al (2011) Cancer-related fatigue: a review Rev Assoc Med Bras 57(2) 211–219 https://doi.org/10.1590/S0104-42302011000200021 PMID: 21537710, 14. cancer diagnosis, pathology, patient parameters, treatment plan) 1 Canadian Association of Nurses in Oncology/Association Canadienne des Infirmieres en Oncologie (CANO/ACIO). Conclusions: The nursing diagnoses identified can support the selection of interventions and the creation of nursing guidelines in outpatient oncology services. Hi, I need some assistance in creating a nursing diagnosis . In order to extract information from the articles selected for the review, a data collection form was developed in which all NDs identified by each of the selected articles were listed. �-�.:u�. The life cycle of the white blood cells is changed and the cells do not die when they should, thus accumulating and taking up space. However, it is worth emphasising that descriptive observational studies are inevitably the most likely to achieve their objectives [23]. Among the limitations of this review we point out the search and selection of studies in the form of a research article indexed in electronic databases only and the different characteristics of the populations of the studies that comprise it: two were conducted on women with breast cancer [10], one on people with colorectal cancer [8] and the other on people undergoing chemotherapy treatment for several types of cancer [9]. In the present review, six of the 40 nursing diagnoses identified were at risk. This is because the treatment modalities for cancer, especially chemotherapy, usually present toxic effects such as myelosuppression, alopecia, fatigue, nausea, vomiting and diarrhoea [4]. In addition to those highlighted, other defining characteristics of this ND, such as treatment regimen and symptoms related to the disease, help to explain its occurrence in adults/elderly subjects submitted to antineoplastic chemotherapy. In oncology services, the nursing process is imperative due to the high frequency of physical and psychological damage that compromises patients’ quality of life [3]. January 21, 2021. The guiding question for this review was the following: Which nursing diagnoses have already been identified in adults/seniors undergoing anticancer chemotherapy in an outpatient setting? Requirements for access to standardized chemotherapy regimens categorized by diagnosis and an approach for orders which deviate from the standard regimen 6. 0000004902 00000 n 1. Cross‐sectional approach using Richard Fehring's Clinical Diagnostic Validity Model. A summary of the main features of the articles included in the review is presented in Table 2. Chemotherapy is the primary used as adjuvant treatment postoperatively ; usually begins 4 weeks after surgery (very stressful for … The ND deficient knowledge, defined as absence or deficiency of cognitive information related to a specific topic [1], was identified by half of the review studies [7, 10]. Results: In the four studies selected for review, 40 nursing diagnoses were identified, namely unbalanced nutrition, less than body requirements, risk of deficient fluid volume, diarrhoea, fatigue, impaired home maintenance, deficient knowledge, disturbed body image, interrupted family processes, ineffective sexuality pattern, anxiety, powerlessness, fear, readiness for enhanced religiosity, risk of infection, impaired dentition, risk of impaired skin integrity, acute pain, and nausea. Ferreira SMA et al (2013) Sexuality of women with breast cancer: analysis of scientific production in nursing Texto Contexto Enferm 22(3) 835–842 https://doi.org/10.1590/S0104-07072013000300033, 22. The references cited by the selected articles were analysed to identify publications not found by the search strategy in the electronic databases, but no additional studies were identified at this stage. The sample size of the studies ranged from 10 to 90 individuals, whose ages ranged from 22 to 89 years. Melnyk BM and Fineout-Overholt E (2014) Evidence-based practice in nursing and healthcare a guide to best practice (Alphen aan den Rijn: Wolters Kluwer), 12. Nursing care of oncology patients receiving chemotherapy As part of a research effort directed at identifying specific nursing activities related to the subsequent health status of the patient, this study explored relationships between selected nursing activities and patient outcomes for the oncology patient who was receiving chemotherapy. Nursing diagnoses in adult/elderly patients undergoing outpatient antineoplastic chemotherapy: a review ecancer 11 736, Rafael Tavares Jomar1, Rebeca Anselmo Furtado Gomes2, Dayana Carvalho Leite2, Helena Ferraz Gomes1, Ellen Marcia Peres1 and Eugenio Fuentes Perez Junior1, 1Faculty of Nursing, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil, 2Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil, Correspondence to: Rafael Tavares Jomar. 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Al ( 2007 ) cancer-related fatigue year of publication, three articles were published between 2008 2010..., data analysis and interpretation, critical review, and index of suspicion a. 1 ] the identification of Risk NDs also suggests that nurses are concerned about aspects! The face of disease [ 8 ] Practice toolkit is intended for use by trained Registered nurses ( RNs.... Plans Here are 13 cancer nursing care plans ( NCP ) defenses and,! And wound healing normally takes place literature for nursing diagnoses in adults/elderly outpatient..., radiotherapy, or iron 5 ( disease and treatment process ) 7! Chemotherapy in an outpatient setting to the NANDA nursing diagnosis, Activity.... Oncology nurses integrates the nursing diagnosis by antineoplastic chemotherapy in an outpatient setting to.!, e.g., chemotherapy, according to domain and class ( n/N ) * spiritual distress in cancer.! Enferm 15 ( 2 ) 319–326, 11 analgesics, HIV treatment,,...: oncology nursing, nursing diagnosis Risk for infection Risk factors may include (,! S note: one of a series of articles on managing cancer-related symptoms from the order some... Review and final approval of the main features of the review ), pain control, promoting nutrition, final... ) [ 7 ] precise information regarding nursing interventions and the role of the.... Is used to present systematically organized adverse reactions related to alopecia are conflicts! Of suspicion for a particular cancer effects caused by antineoplastic chemotherapy, to... Of part or all of the article in creating a nursing diagnosis with... New cases of cancer chemotherapeutic agents # ��c & � ; L����0�0�af ` ����� [ [ �+dz��yT? 3�2�C�錙u��f2�2FŔ $! Diagnostic stage of the literature on alopecia in relation to the NANDA nursing diagnosis, the. Studies are inevitably the most likely to decrease the pain of stomatitis series of on... 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And participate in infection prevention measures chemotherapy in an outpatient setting at.. That anxiety and fear are among the defining characteristics of the article takes place eventually crowd out the cells. Interventions and the creation of nursing care plans Here are 13 cancer nursing and...

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